Information Extraction from the Text Data on Traditional Chinese Medicine: A Review on Tasks, Challenges, and Methods from 2010 to 2021.

Background: The practice of traditional Chinese medicine (TCM) began several thousand years ago, and the knowledge of practitioners is recorded in paper and electronic versions of case notes, manuscripts, and books in multiple languages. Developing a method of information extraction (IE) from these sources to generate a cohesive data set would be a great contribution to the medical field. The goal of this study was to perform a systematic review of the status of IE from TCM sources over the last 10 years. Methods: We conducted a search of four literature databases for articles published from 2010 to 2021 that focused on the use of natural language processing (NLP) methods to extract information from unstructured TCM text data. Two reviewers and one adjudicator contributed to article search, article selection, data extraction, and synthesis processes. Results: We retrieved 1234 records, 49 of which met our inclusion criteria. We used the articles to (i) assess the key tasks of IE in the TCM domain, (ii) summarize the challenges to extracting information from TCM text data, and (iii) identify effective frameworks, models, and key findings of TCM IE through classification. Conclusions: Our analysis showed that IE from TCM text data has improved over the past decade. However, the extraction of TCM text still faces some challenges involving the lack of gold standard corpora, nonstandardized expressions, and multiple types of relations. In the future, IE work should be promoted by extracting more existing entities and relations, constructing gold standard data sets, and exploring IE methods based on a small amount of labeled data. Furthermore, fine-grained and interpretable IE technologies are necessary for further exploration.

Constructing fine-grained entity recognition corpora based on clinical records of traditional Chinese medicine.

BACKGROUND: In this study, we focus on building a fine-grained entity annotation corpus with the corresponding annotation guideline of traditional Chinese medicine (TCM) clinical records. Our aim is to provide a basis for the fine-grained corpus construction of TCM clinical records in future. METHODS: We developed a four-step approach that is suitable for the construction of TCM medical records in our corpus. First, we determined the entity types included in this study through sample annotation. Then, we drafted a fine-grained annotation guideline by summarizing the characteristics of the dataset and referring to some existing guidelines. We iteratively updated the guidelines until the inter-annotator agreement (IAA) exceeded a Cohen's kappa value of 0.9. Comprehensive annotations were performed while keeping the IAA value above 0.9. RESULTS: We annotated the 10,197 clinical records in five rounds. Four entity categories involving 13 entity types were employed. The final fine-grained annotated entity corpus consists of 1104 entities and 67,799 tokens. The final IAAs are 0.936 on average (for three annotators), indicating that the fine-grained entity recognition corpus is of high quality. CONCLUSIONS: These results will provide a foundation for future research on corpus construction and named entity recognition tasks in the TCM clinical domain.

Serum metabonomic analysis of protective effects of Curcuma aromatica oil on renal fibrosis rats.

BACKGROUND: Curcuma aromatica oil is a traditional herbal medicine demonstrating protective and anti-fibrosis activities in renal fibrosis patients. However, study of its mechanism of action is challenged by its multiple components and multiple targets that its active agent acts on. METHODOLOGY/PRINCIPAL FINDINGS: Nuclear magnetic resonance (NMR)-based metabonomics combined with clinical chemistry and histopathology examination were performed to evaluate intervening effects of Curcuma aromatica oil on renal interstitial fibrosis rats induced by unilateral ureteral obstruction. The metabolite levels were compared based on integral values of serum 1H NMR spectra from rats on 3, 7, 14, and 28 days after the medicine administration. Time trajectory analysis demonstrated that metabolic profiles of the agent-treated rats were restored to control levels after 7 days of dosage. The results confirmed that the agent would be an effective anti-fibrosis medicine in a time-dependent manner, especially in early renal fibrosis stage. Targeted metabolite analysis showed that the medicine could lower levels of lipid, acetoacetate, glucose, phosphorylcholine/choline, trimethylamine oxide and raise levels of pyruvate, glycine in the serum of the rats. Serum clinical chemistry and kidney histopathology examination dovetailed well with the metabonomics data. CONCLUSIONS/SIGNIFICANCES: The results substantiated that Curcuma aromatica oil administration can ameliorate renal fibrosis symptoms by inhibiting some metabolic pathways, including lipids metabolism, glycolysis and methylamine metabolism, which are dominating targets of the agent working in vivo. This study further strengthens the novel analytical approach for evaluating the effect of traditional herbal medicine and elucidating its molecular mechanism.

Supervised methods for symptom name recognition in free-text clinical records of traditional Chinese medicine: an empirical study.

Clinical records of traditional Chinese medicine (TCM) are documented by TCM doctors during their routine diagnostic work. These records contain abundant knowledge and reflect the clinical experience of TCM doctors. In recent years, with the modernization of TCM clinical practice, these clinical records have begun to be digitized. Data mining (DM) and machine learning (ML) methods provide an opportunity for researchers to discover TCM regularities buried in the large volume of clinical records. There has been some work on this problem. Existing methods have been validated on a limited amount of manually well-structured data. However, the contents of most fields in the clinical records are unstructured. As a result, the previous methods verified on the well-structured data will not work effectively on the free-text clinical records (FCRs), and the FCRs are, consequently, required to be structured in advance. Manually structuring the large volume of TCM FCRs is time-consuming and labor-intensive, but the development of automatic methods for the structuring task is at an early stage. Therefore, in this paper, symptom name recognition (SNR) in the chief complaints, which is one of the important tasks to structure the FCRs of TCM, is carefully studied. The SNR task is reasonably treated as a sequence labeling problem, and several fundamental and practical problems in the SNR task are studied, such as how to adapt a general sequence labeling strategy for the SNR task according to the domain-specific characteristics of the chief complaints and which sequence classifier is more appropriate to solve the SNR task. To answer these questions, a series of elaborate experiments were performed, and the results are explained in detail.

A framework and its empirical study of automatic diagnosis of traditional Chinese medicine utilizing raw free-text clinical records.

Automatic diagnosis is one of the most important parts in the expert system of traditional Chinese medicine (TCM), and in recent years, it has been studied widely. Most of the previous researches are based on well-structured datasets which are manually collected, structured and normalized by TCM experts. However, the obtained results of the former work could not be directly and effectively applied to clinical practice, because the raw free-text clinical records differ a lot from the well-structured datasets. They are unstructured and are denoted by TCM doctors without the support of authoritative editorial board in their routine diagnostic work. Therefore, in this paper, a novel framework of automatic diagnosis of TCM utilizing raw free-text clinical records for clinical practice is proposed and investigated for the first time. A series of appropriate methods are attempted to tackle several challenges in the framework, and the Naïve Bayes classifier and the Support Vector Machine classifier are employed for TCM automatic diagnosis. The framework is analyzed carefully. Its feasibility is validated through evaluating the performance of each module of the framework and its effectiveness is demonstrated based on the precision, recall and F-Measure of automatic diagnosis results.

Automatic symptom name normalization in clinical records of traditional Chinese medicine.

BACKGROUND: In recent years, Data Mining technology has been applied more than ever before in the field of traditional Chinese medicine (TCM) to discover regularities from the experience accumulated in the past thousands of years in China. Electronic medical records (or clinical records) of TCM, containing larger amount of information than well-structured data of prescriptions extracted manually from TCM literature such as information related to medical treatment process, could be an important source for discovering valuable regularities of TCM. However, they are collected by TCM doctors on a day to day basis without the support of authoritative editorial board, and owing to different experience and background of TCM doctors, the same concept might be described in several different terms. Therefore, clinical records of TCM cannot be used directly to Data Mining and Knowledge Discovery. This paper focuses its attention on the phenomena of "one symptom with different names" and investigates a series of metrics for automatically normalizing symptom names in clinical records of TCM. RESULTS: A series of extensive experiments were performed to validate the metrics proposed, and they have shown that the hybrid similarity metrics integrating literal similarity and remedy-based similarity are more accurate than the others which are based on literal similarity or remedy-based similarity alone, and the highest F-Measure (65.62%) of all the metrics is achieved by hybrid similarity metric VSM+TFIDF+SWD. CONCLUSIONS: Automatic symptom name normalization is an essential task for discovering knowledge from clinical data of TCM. The problem is introduced for the first time by this paper. The results have verified that the investigated metrics are reasonable and accurate, and the hybrid similarity metrics are much better than the metrics based on literal similarity or remedy-based similarity alone.